Organization
CENTRAL STATE HOSPITAL
Active
Parent organization
COMMONWEALTH OF KENTUCKY
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF KENTUCKY
Authorized official
MARK L REYNOLDS (CONTROLLER)
(502) 253-7135
Entity
Organization
Contact information
Practice address
10510 LAGRANGE RD, LOUISVILLE, KY 40223-1277
(502) 253-7135
(502) 253-7044
Mailing address
10510 LAGRANGE ROAD, LOUISVILLE, KY 40223-1277
(502) 253-7044
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
100198
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02021293
—
KY
Enumeration date
06/14/2005
Last updated
07/30/2010
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